Pathophysiology, Diagnosis, and Management of Chronic Spontaneous Urticaria: A Literature Review

Benjamin Greiner, Savannah Nicks, Michael Adame, Jennifer McCracken

Research output: Contribution to journalReview articlepeer-review

4 Scopus citations


Chronic spontaneous urticaria (CSU) is characterized by recurring wheals that last 6 weeks or longer without an identifiable cause. The estimated point prevalence of CSU worldwide is 1%. Furthermore, it has a significant impact on quality of life in both adults and pediatric patients and their families. Although it is most often a self-limited disease, some patients have urticaria refractory to first-line treatment: second-generation H1 antihistamines. In these patients, the use of targeted monoclonal antibodies is necessary. While omalizumab is the only Food and Drug Administration-approved monoclonal antibody for CSU, others, including ligelizumab, dupilumab, benralizumab, and several orally administered Bruton’s tyrosine kinase inhibitors, are also promising therapeutics for reducing the morbidity of CSU. Novel therapies, among others discussed here, are rapidly being developed with new trials and therapeutics being released nearly monthly. Thus, we performed a scoping literature review of randomized controlled trials studying targeted therapies for CSU. We also discuss the pathophysiology, diagnosis, prognosis, and future research directions in CSU.

Original languageEnglish (US)
Pages (from-to)381-389
Number of pages9
JournalClinical Reviews in Allergy and Immunology
Issue number3
StatePublished - Dec 2022


  • Chronic idiopathic urticaria
  • Chronic spontaneous urticaria
  • Management
  • Systematic review
  • Targeted therapy

ASJC Scopus subject areas

  • Immunology and Allergy


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